Bowel cancer: new plans to reshape the screening programme

Despite there being a dramatic increase in bowel cancer
cases above the age of 50, the screening programme in England is currently only
offered to those aged 60 and over. However, Public Health England have recently
announced that it plans to bring the starting age for screening down to 50, a
move which will mean countless more cases are spotted in the earlier, more
easily treatable stages. (1)

What is bowel cancer?

Bowel cancer is cancer of the large intestine, and depending
on the area affected, may be referred to as colon cancer or rectal cancer. It
is the fourth most commonly diagnosed cancer in the UK, responsible for 42,000
cases and over 16,000 deaths each year. (1, 2)

What are the
symptoms?

One of the most common symptoms is blood in your poo. This
may be noticed as red streaks on the surface of your poo or the poo being
discoloured (red, very dark red/brown or black), toilet water being stained red
or pink, or blood visible on toilet paper. Often, blood in poo has other, less
serious causes, such as haemorrhoids or anal fissures (cuts). But if you’ve had
any of the above symptoms for three weeks or longer, visit your GP. (2, 3)

A change in bowel habit can also be a sign of bowel cancer.
One off changes in bowel habit can be caused by eating certain foods or
stressful situations, but if this occurs persistently don’t ignore it. If you
find you are needing to poo more frequently than what’s usual for you, and the
poo is softer and thinner than usual for three weeks or more, see your GP.
(2,3)

Another common symptom is lower abdominal pain, discomfort
or bloating. This tends to worsen after eating and may therefore put you off
eating, leading to weight loss. See your GP if you experience any of the above
symptoms. (2, 3)

Other symptoms may include tiredness from anaemia caused by
persistent blood loss from the bowel, slime in your poo and feeling like you
can’t fully empty your bowel when you poo. (2, 3)

Bowel cancer screening

Currently, the bowel cancer screening programme in England
involves inviting everyone aged between 60 and 74 to have a faecal occult blood
(FOB) test every two years. This is a simple home testing kit which allows a
small stool sample to be collected. When sent to the laboratory, this sample is
tested for traces of blood, which could indicate bowel cancer. (1, 2)

A new, more accurate bowel screening kit is due to replace
the FOB test this autumn, known as the faecal immunochemical test (FIT). It is
the FIT that will be in use when bowel screening is introduced to people aged
50 and over in England. (1)

In some parts of England, a different test is also offered
to 55 year olds, called bowel scope screening. During this screening, a
healthcare professional will inspect the lower bowel for polyps (small growths
that can be an early sign of cancer) using a gentle instrument. (2)

What causes bowel
cancer?

Bowel cancer, like all cancers, doesn’t have a definite
cause, but there are several risk factors:

Regularly eating red or processed meat

Not eating enough fibre

Being overweight or obese

Sedentary lifestyle

Excessive alcohol consumption

Smoking

Being 60 years of age or older

Having a parent or sibling who had bowel cancer
under 50 years of age

Having had ulcerative colitis or Crohn’s disease
for over 10 years

As you can see, some factors are unavoidable, but others can
be changed. A diet high in fibre, fruit and vegetables and low in red and
processed meat will help protect against bowel cancer, as will stopping smoking
(if applicable), drinking alcohol in moderation or not at all, getting moderate
exercise regularly and maintaining or attaining a healthy weight. (2)